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Ahmad MZ. Assessment of Debris Extrusion in Curved Canals: An In Vitro Analysis of Various Single-File Endodontic Instrumentation Systems. Int J Dent 2024; 2024:8367693. [PMID: 39007058 PMCID: PMC11245337 DOI: 10.1155/2024/8367693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/27/2024] [Accepted: 05/31/2024] [Indexed: 07/16/2024] Open
Abstract
Objectives Rotary single-file endodontic systems are commonly used for root canal treatment. However, very few studies have evaluated the apical extrusion of debris generated by these systems during canal preparation at normal body temperature in laboratory conditions. The aim of this study was to evaluate the amount of apically extruded debris caused by seven different single-file endodontic instrumentation systems at body temperature in mandibular molar teeth with curved root canals. Methods One hundred forty mandibular first permanent molars were randomly divided into seven groups (n = 20) to be prepared by one of the following systems at 35°C: Reciproc Blue (REC Blue), WaveOne Gold (WOG), One Reci (OR), Neoniti, HyFlex EDM (HEDM), One Curve (OC), or XP Shaper (XPS). Debris was collected into preweighted Eppendorf tubes. The weight of the extruded debris was recorded by subtracting the weight of the tooth-free apparatus from the post-procedure weight. Data were analyzed by one-way ANOVA and Tukey's tests (p < 5%). Results REC Blue, WOG, and OR groups extruded significantly more debris from the apex than XPS, OC, and Neoniti groups (p < 0.05). No significant difference was observed among the XPS, OC, Neoniti, and HEDM groups (p > 0.05). Conclusion All the instruments were associated with debris extrusion. However, REC Blue, WOG, and OR extrude significantly more debris than other instruments. The amount of debris with different files was REC Blue > OR > WOG > HEDM > OC > Neoniti > XPS. XPS, Neoniti, and OC caused significantly less extrusion of debris than REC Blue, WOG, and OR.
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Affiliation(s)
- Muhammad Zubair Ahmad
- Department of Conservative Dental Sciences College of Dentistry Qassim University, Buraydah 52571, Saudi Arabia
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Tartari T, Wilchenski BS, de Souza Lima LA, Vivan RR, Ballal V, Duarte MAH. The use of sodium hypochlorite mixed with etidronic acid during canal preparation increases debris extrusion. AUST ENDOD J 2023; 49:584-591. [PMID: 37571801 DOI: 10.1111/aej.12788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023]
Abstract
The purpose of this study was to compare the impact of different irrigation protocols on debris extrusion. Single-rooted teeth were distributed into groups based on the irrigation protocols (n = 40): 2.5% NaOCl (biomechanical preparation: 20 mL and final irrigation: 5 mL); 2.5% NaOCl (biomechanical preparation: 20 mL) + 17% EDTA (final irrigation: 2 mL) + 2.5% NaOCl (final irrigation: 3 mL); and a mixture of 5% NaOCl +18% HEDP (biomechanical preparation: 20 mL and final irrigation: 5 mL). The canals were prepared using a reciprocating instrument size 40/0.06. For final irrigation, the groups were reassigned based on the agitation methods (n = 10): (a) no agitation; (b) ultrasonic; (c) sonic; and (d) continuous rotation. The control group (n = 10) received saline solution without agitation. The amount of debris extruded was measured by weight and analysed using One-way ANOVA (α < 0.05). The subgroups treated with NaOCl + HEDP mixture showed a significantly higher amount of extruded debris (p < 0.05), while there was no difference among agitation methods in all groups (p > 0.05).
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Affiliation(s)
- Talita Tartari
- Department of Restorative Dentistry, Piracicaba School of Dentistry, State University of Campinas, Piracicaba, Brazil
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Brenda Stefhany Wilchenski
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Luana Arantes de Souza Lima
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Vasudev Ballal
- Department of Conservative Dentistry & Endodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Koşar T, Çelik D, Taşdemir T. Apically extruded debris of different file systems used with various kinematic movements during retreatment: An in vitro study. AUST ENDOD J 2023; 49 Suppl 1:33-40. [PMID: 36125950 DOI: 10.1111/aej.12690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/05/2022] [Accepted: 09/03/2022] [Indexed: 11/28/2022]
Abstract
This study aimed to examine the amount of apically extruded debris and time during retreatment with five current file systems, which exhibit various kinematic movements. One hundred upper central incisors were shaped with manual files and filled using the thermoplastic injection method. The root canal fillings in each group (n = 20) were removed using the Genius (GN), ProTaper Next (PTN), Reciproc (RCP) Blue, Tango-Endo (TE) and Twisted File Adaptive (TFA) file systems. The apically extruded debris was collected in preweighed Eppendorf tubes. Time to reach working length and total time were also recorded. The PTN, RCP Blue and TFA instruments caused significantly less apically extruded debris and shorter total retreatment time than the GN and TE file systems (p < 0.05). The time to reach the working length was the shortest in the PTN group compared to the other groups (p < 0.05). All file systems extruded debris while removing the root canal filling.
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Affiliation(s)
- Tuğba Koşar
- Department of Endodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Davut Çelik
- Department of Endodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Tamer Taşdemir
- Department of Endodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
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Kurt Ö, Zengin T, Üstün Y. Comparison of the effect of different glide path files on amount of apically extruded debris in curved root canals. AUST ENDOD J 2023; 49 Suppl 1:359-365. [PMID: 36946545 DOI: 10.1111/aej.12749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/30/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
It is essential to create a glide path before root canal preparation with nickel-titanium rotary files to avoid file breakage and preserve the original canal structure. The aim of this study was to compare the amount of apically extruded debris after using different glide path files. A total of 96 first mandibular molars with curved mesial roots were randomly divided into six groups (n = 16) which are K-files, Proglider, R-Pilot, TruNatomy Glider, WaveOne Gold Glider and group without a glide path. Apically extruded debris was measured after glide path and canal preparation. The highest amount of debris was found in the control group without a glide path and using a glide path file caused less debris and significant differences were observed between R-Pilot, TruNatomy Glider, ProGlider, WaveOne Gold Glider and K-file groups. It may be recommended to create a glide path before root canal shaping to reduce the amount of extrusion debris from the apical. Especially in curved and narrow root canals, it is recommended to use an R-Pilot file before root canal shaping in order to reduce the amount of apically extruded debris.
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Affiliation(s)
- Özge Kurt
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Talip Zengin
- Department of Molecular Biology and Genetics, Muğla Sitki Koçman University, Muğla, Turkey
| | - Yakup Üstün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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5
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Azizi Mazreah S, Shirvani A, Azizi Mazreah H, Dianat O. Evaluation of irrigant extrusion following the use of different root canal irrigation techniques: A systematic review and meta-analysis. AUST ENDOD J 2023; 49:396-417. [PMID: 35988128 DOI: 10.1111/aej.12678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
This systematic review investigates whether different irrigation techniques have different effects on irrigant extrusion from mature tooth apices. Articles published between January 2000 and January 2022 were searched in six electronic databases (MEDLINE, Embase, Google Scholar, Web of Science, Scopus and Cochrane) using appropriate keywords. Overall, 2265 articles were screened by their titles and abstracts. Fifty-six full-text articles were selected based on the inclusion criteria. Of them, 17 in vitro studies were included in the systematic review and meta-analysis. The meta-analysis was conducted using the random-effects inverse variance method. The results showed that the negative pressure technique caused a lesser amount (p = 0.00) and frequency (p = 0.00) of extrusion than the open-ended needle irrigation. Sonic and ultrasonic activation caused less amount of extrusion than both open-ended (p = 0.00 or p = 0.01) and closed-ended needle (p = 0.00) irrigation.
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Affiliation(s)
| | - Armin Shirvani
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Omid Dianat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
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Habeeb MA. Comparative evaluation of debris and irrigation extruded apically using different design of needles and penetration depth - An In Vitro study. Indian J Dent Res 2023; 34:266-269. [PMID: 38197344 DOI: 10.4103/ijdr.ijdr_32_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
Aim : The aim of this study was to measure the amount of material extruded in the periapical area using three irrigation needles (Max-I-Probe, NaviTip Fx and IrriFlex flexible needle). Materials and Methods : Mandibular premolars were selected for this study and glass vials were used to gather the extruded debris and they were preweighed. The samples were divided into two groups: Group A (1 mm penetration of needle from working length), which was subdivided into three subgroups: Subgroup A1: Irrigation was made by Max-I-Probe. Subgroup A2: Irrigation was made by NaviTip Fx. Subgroup A3: Irrigation was made by IrriFlex flexible needle. Group B (3 mm penetration of needle), which was subdivided into three subgroups: Subgroup B1: Irrigation was made by Max-I-Probe. Subgroup B2: Irrigation was made by NaviTip Fx. Subgroup B3: Irrigation was made by IrriFlex flexible needle. XP-endo Shaper was used for chemomechanical preparation. After removal from vials, the teeth were incubated and then removed from the incubator and weighed again three times. The average of the readings was taken. Analysis of variance (ANOVA) and least significance difference tests were applied to analyse data. Results : All of the needles caused debris extrusion. There was a significant difference between groups (P ≤ 0.001) according to the depth of penetration. The lowest value for debris was observed in subgroup B3 while subgroup A2 had shown the highest mean. Conclusion Results revealed that the design and depth of needles significantly affected the debris extrusion. Using more flexible needles and shorter penetration depth for irrigation so that we don't need to push the needles so far apically.
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Affiliation(s)
- Maha A Habeeb
- Department of Conservative Dentistry, College of Dentistry, University of Uruk, Baghdad, Iraq
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7
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Ada KS, Shetty S, Jayalakshmi KB, Nadig PL, Manje Gowda PG, Selvan AK. Influence of different irrigant activation methods on apical debris extrusion and bacterial elimination from infected root canals. J Conserv Dent 2023; 26:31-35. [PMID: 36908725 PMCID: PMC10003277 DOI: 10.4103/jcd.jcd_378_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/28/2022] [Accepted: 08/19/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction The study aimed to determine the apical debris extrusion and microbial elimination from infected root canals after using different irrigant activation methods. Materials and Methods Forty freshly extracted human mandibular premolars were selected and randomly assigned to four groups (n = 10). The teeth were mechanically prepared, sterilized, and inoculated with Enterococcus faecalis for 1 week. Irrigation was done with 3% sodium hypochlorite following conventional syringe irrigation-Group 1, manual dynamic agitation (MDA)-Group 2, passive ultrasonic irrigation (PUI)-UltraX -Group 3, and sonic irrigation (SI)-EndoActivator -Group 4, and the extruded debris were collected using Myers and Montgomery model. The microbial samples were taken from the canals using sterile paper points, cultured and recorded as colonies. The amount of extruded debris was measured by subtracting the final weight of the Eppendorf tube with debris from the initial weight of the tube. Results I. Group 3 showed the least apical debris extrusion (P < 0.05), followed by Groups 2 and 1 and the highest with Group 4. II. Group 3 showed the least colony-forming units (CFUs)/ml, followed by Group 4, and finally, Group 2 showed lesser mean CFUs/ml compared to Group 1 (P < 0.05). Conclusion All the irrigation activation methods were associated with apical debris extrusion, with the PUI system extruding the least amount of debris compared to the other groups. Irrigation activation techniques were beneficial in reducing the microbial load from the infected canals with the PUI system showing a complete elimination of the microbes, followed by SI and MDA.
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Affiliation(s)
- K. Sadia Ada
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Shibani Shetty
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - K. B. Jayalakshmi
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Prasanna Latha Nadig
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - P. G Manje Gowda
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Arul K. Selvan
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
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Uygun AD. Comparison of apical debris extrusion of different generation nickel-titanium instrument systems. Niger J Clin Pract 2022; 25:2010-2015. [PMID: 36537459 DOI: 10.4103/njcp.njcp_455_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND AIM The aim of this study is to evaluate the apical debris extrusion amounts and preparation times of four different nickel-titanium systems with a similar cross-section design-Mtwo, RECIPROC, RECIPROC blue, and VDW.ROTATE. MATERIALS AND METHODS Eighty human mandibular central incisors were divided into four equal groups (n = 20). The test apparatus was inserted into an assembly that provided root canal temperature. Preparation times were recorded using a stopwatch, and the amount of extruded debris was collected in pre-weighed Eppendorf tubes. After drying, the net amount was determined by subtracting the previously measured Eppendorf tube weights from the total weight. RESULTS The Mtwo had the largest amount of debris, but there was no significant difference among the other groups. The VDW.ROTATE completed the preparation in a significantly shorter time than the RECIPROC blue and Mtwo. CONCLUSION Compared to other files, the Mtwo sequence produced significantly more debris and required significantly more time to complete the whole root canal preparation.
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Affiliation(s)
- A D Uygun
- Department of Endodontics, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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9
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Haridoss S, R B, Swaminathan K, P A. Shaping Properties and Outcomes of Nickel-Titanium Reciprocation Systems in Primary Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies. Cureus 2022; 14:e30995. [DOI: 10.7759/cureus.30995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 11/07/2022] Open
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10
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SERÇE FİKİRLİ B, ALTUNKAYNAK B, KAYAOĞLU G. Kök kanal geometrisinin ve iğne tipinin apikalden irrigan taşmasına etkisi: ex vivo çalışma. ACTA ODONTOLOGICA TURCICA 2022. [DOI: 10.17214/gaziaot.945129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective: The aim was to evaluate the effect of root canal geometry on the amount of apical extrusion of irrigant, by testing different tapers and needle types.
Materials and Method: Forty-three extracted single-rooted human mandibular premolar teeth were accessed. Experimental groups were instrumented to produce increasing amounts of taper in each successive group: Group 1 (#25/.02), Group 2 (#25/.04), Group 3 (#25/.06), and Group 4 (#25/.08) (n=43, each). Irrigation was done sequentially by using a 30-G open-ended flat needle, 30-G close-ended side-vented needle, and 27-G open-ended beveled needle. Flat and side-vented needles were each placed 3 mm short of the apex, while the beveled needle was placed as far as possible in the canal without binding. Extruded irrigant was collected in preweighed foam cubes. Statistical significance was set at p<0.05.
Results: An increase in canal taper led to a decrease in the amount of extruded irrigant for the flat needle (p<0.05; Groups 1 and 2 versus 3 and 4) and side-vented needle (p<0.05; Groups 1 and 2 versus 4), but no significant effect was found for the beveled needle. The amount of extruded irrigant was greater with the flat than with the side-vented needle at all tapers and with the beveled needle at most tapers (p<0.05). The side-vented needle was generally associated with the least amount of extrusion.
Conclusion: Given a constant needle insertion depth, the amount of apically extruded irrigant decreased as canal taper increased. The greatest and least amounts of extrusion were generally observed with the flat and side-vented needle, respectively.
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Affiliation(s)
| | | | - Güven KAYAOĞLU
- Department of Endodontics, Faculty of Dentistry, Gazi University
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Comparative Evaluation of Apically Extruded Debris during Pulpectomy Procedure in Primary Molar Teeth Using Two Different Rotary Systems and Hand Files: An In Vitro Study. Int J Dent 2022; 2022:9433225. [PMID: 35706458 PMCID: PMC9192212 DOI: 10.1155/2022/9433225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 04/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background Successful outcome of endodontic treatment depends on chemomechanical preparation of the tooth. However, during canal preparation, debris may extrude through the apical foramen causing postoperative complications. The aim of this study is to evaluate and compare the amount of apically extruded debris during the pulpectomy procedure in primary molar teeth using two different rotary files and hand files. Materials and Methods Distal roots of sixty extracted primary molars were divided into three groups: group A: Prime Pedo™ pediatric rotary files, group B: DXL-Pro Pedo™ pediatric rotary files, and group C: hand files. Myers and Montgomery experimental model was used. Preweighed Eppendorf tubes were used to collect apically extruded debris. The tubes were then placed in an incubator at 70°C for 5 days. The weight of the debris attained was determined. The data were analyzed using ANOVA and post hoc Bonferroni test. Results Hand files produced more apical debris extrusion (P < 0.05). Prime Pedo™ pediatric rotary files produced the least debris (P < 0.05). Conclusion Prime Pedo™ and DXL-Pro Pedo™ pediatric rotary files extruded significantly lower amount of debris apically during pulpectomy as compared to hand files. Rotary files can be considered an alternative to hand files in pediatric endodontics.
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Bnaiyan AH, Altinawi MK, Lazkani T, Alzoubi H. Evaluation Time and Efficacy of Root Canal Rotary Preparation in Primary Teeth: An In-Vitro Study. Cureus 2022; 14:e24558. [PMID: 35664392 PMCID: PMC9148183 DOI: 10.7759/cureus.24558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/05/2022] Open
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Boutsioukis C, Arias-Moliz MT, Chávez de Paz LE. A critical analysis of research methods and experimental models to study irrigants and irrigation systems. Int Endod J 2022; 55 Suppl 2:295-329. [PMID: 35171506 PMCID: PMC9314845 DOI: 10.1111/iej.13710] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-omputed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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14
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Chalub LO, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Dos Santos PH, Gomes-Filho JE, Cintra LTA, Sivieri-Araujo G. Postoperative pain in root canal treatment with ultrasonic versus conventional irrigation: a systematic review and meta-analysis of randomized controlled trials. Clin Oral Investig 2022; 26:3343-3356. [DOI: 10.1007/s00784-022-04386-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/11/2022] [Indexed: 11/03/2022]
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15
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Tanalp J. A critical analysis of research methods and experimental models to study apical extrusion of debris and irrigants. Int Endod J 2022; 55 Suppl 1:153-177. [DOI: 10.1111/iej.13686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- J Tanalp
- Yeditepe University Faculty of Dentistry Department of Endodontics Istanbul Turkey
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16
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Sundar S, Varghese A, Datta KJ, Natanasabapathy V. Effect of guided conservative endodontic access and different file kinematics on debris extrusion in mesial root of the mandibular molars: An in vitro study. J Conserv Dent 2022; 25:547-554. [PMID: 36506635 PMCID: PMC9733558 DOI: 10.4103/jcd.jcd_273_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/15/2022] Open
Abstract
Background Guided conservative endodontic access is a novel technique and the influence of such access cavities on apical debris extrusion (ADE) can have a significant effect on postoperative pain. Objective This study compared ADE and preparation time (PT) in the mesial canals of the mandibular first permanent molars in different access cavity designs and the amount of sodium hypochlorite in the extruded debris using attenuated total reflection-Fourier transform infrared spectrometer (ATR-FTIR). Materials and Methods Human mandibular first permanent molars (N = 72) were selected and randomly divided into six groups (n = 12) based on type of cavity design and files used: Group 1, Conservative Access Cavity [ConsAC])-WaveOne Gold; Group 2, ConsAC-Mtwo; Group 3, ConsAC-XP-endo shaper; Group 4, Traditional Access Cavity [TradAC])-WaveOne; Group 5, TradAC-Mtwo; and Group 6, TradAC-XP-endo shaper. All the ConsAC were prepared with a customized template fabricated using cone beam computed tomography. ADE evaluation was done using the Myers and Montgomery set up. All the instruments were used according to the manufacturers' instructions, followed by a final irrigation using Endoactivator. The time taken for preparation was calculated using a digital watch. Five samples in each group was taken and subjected to ATR-FTIR analysis. Results There was no significant difference between the groups with respect to ADE (P > 0.05). Whereas, a statistically significant difference was seen in PT between the TradAC and ConsAC (P < 0.05). Using ATR-FTIR, it was found that all the samples of extruded debris had the presence of sodium hypochlorite. Conclusions All instrumentation systems produced ADE irrespective of access cavity design. The time taken for preparation of canals in ConsAC was significantly longer compared to TradAC. Clinical Relevance ADE can translate clinically as postoperative pain. Assessing the ADE in ConsAC could shed light on the type of file systems that can be used in such cavities in order to minimize postoperative pain clinically.
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Affiliation(s)
- Sathish Sundar
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India,Address for correspondence: Dr. Sathish Sundar, Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, No. 1, Alapakkam Main Road, Maduravoyal, Chennai - 600 095, Tamil Nadu, India. E-mail:
| | - Aswathi Varghese
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India
| | - Krithika J. Datta
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Velmurugan Natanasabapathy
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India
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Namsoy E, Serefoglu B, Hulsmann M, Caliskan MK. Influence of various application systems on the amount of extruded irrigant in simulated immature teeth with regard to gravity: An ex-vivo study. Niger J Clin Pract 2022; 25:1831-1837. [DOI: 10.4103/njcp.njcp_270_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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18
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Apically Extruded Debris in Curved Root Canals Using a New Reciprocating Single-File Shaping System. J Endod 2021; 48:117-122. [PMID: 34699902 DOI: 10.1016/j.joen.2021.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The present study addresses the influence of 5 different shaping file systems on apical debris extrusion (AED) using 2 different irrigation protocols. METHODS One hundred fifty mandibular first permanent molars were divided into 2 groups and 10 subgroups. The mesial root canals were shaped using One Reci (MicroMega), WaveOne Gold Primary (Dentsply Sirona, York, PA), and ProTaper Next (Dentsply Sirona) using reciprocating motion and One Curve (MicroMega) and ProTaper Next using continuous rotation. The first group and the second one were respectively irrigated with 10 and 5 mL distilled water. RESULTS When the same instrumentation technique was used, the G10 mL subgroups showed statistically lower AED than the G5 mL subgroups (P < .05). The One Reci and One Curve subgroups, in both groups, produced statistically lower AED than the remaining subgroups. CONCLUSIONS The cross section of the instrument could be the main parameter in determining the amount of AED. The irrigation volume used during the shaping procedure might affect the amount of AED.
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19
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Eliasz W, Czarnecka B, Surdacka A. Apical Extrusion of Debris during Root Canal Preparation with ProTaper Next, WaveOne Gold and Twisted Files. MATERIALS 2021; 14:ma14216254. [PMID: 34771780 PMCID: PMC8585032 DOI: 10.3390/ma14216254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/25/2022]
Abstract
(1) Background: Apical extrusion of debris is an example of a complication that may arise during root canal treatment, and it has been proven to be an unavoidable occurrence during endodontic treatment by numerous authors. Even though it may not hinder the long-term outcome of treatment, it may lead directly to increased levels of postoperative pain and, therefore, lower levels of patient acceptance and satisfaction. The aim of the study was to assess the weight of apically extruded debris during root canal preparation with instruments that use different movement kinematics (rotary, reciprocating, and adaptive motion); (2) Methods: The study was performed using the Myers and Montgomery model. Sixty human premolar teeth were inserted into preweighed Eppendorf tubes and randomly classified into three groups. After manual glide-path preparation, teeth in each group were instrumented to working length set 1 mm short of the anatomical apex using the standard sequence provided by the manufacturers (for Group 1: ProTaper Next X1 & X2; for Group 2: WaveOne Gold Primary, for Group 3: Twisted Files SM1-SM3). Root canals were irrigated with 1 mL of 0.9% NaCl solution between each file insertion. The tubes with collected debris were stored in an incubator at 70 °C for 5 days in order to evaporate the liquid component. Measurement of the weight of extruded debris was performed by subtracting the preinstrumentation from the postinstrumentation weight of the tubes. The results were analyzed with Kruskal-Wallis ANOVA, with significance level set at 0.05; (3) Results: The weight of extruded debris was 0.337 mg (SD = 0.148) for Group 1, 0.305 mg (SD = 0.201) for Group 2, and 0.348 mg (SD = 0.135) for Group 3. (4) Conclusions: Engine-driven root canal preparation with the use of instruments ProTaper Next, WaveOne Gold and Twisted Files that use different movement kinematics (rotary, reciprocating, and adaptive motion) was associated with apical extrusion of debris to a similar extent.
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Affiliation(s)
- Wojciech Eliasz
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
- Correspondence: ; Tel.: +48-732-571-657
| | - Beata Czarnecka
- Department of Biomaterials and Experimental Dentistry, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
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20
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Nabavizadeh M, Shokouhi MM, Kheirandish M, Sahebi S, Sadatshojaee N, Abbaszadegan A. A Comparison of the Apical Extrusion of Debris during the Preparation of Root Canal with Medin, RaCe, and ProTaper Rotary Systems. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:193-197. [PMID: 34514067 PMCID: PMC8417540 DOI: 10.30476/dentjods.2020.84776.1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/20/2020] [Accepted: 09/12/2020] [Indexed: 11/19/2022]
Abstract
Statement of the Problem: The extrusion of intracanal debris is one of the challenging problems related to almost all root canal preparation systems, which may cause flare-ups and impairment in the healing process. Purpose: This study was conducted to evaluate the amount of apically-extruded debris during root canal preparation using Medin (MEDIN Co., Czech Republic) rotary system compared with
two common rotary systems, including ProTaper (Dentsply Maillefer., Switzerland) and RaCe (FKG Dentaire, Switzerland). Materials and Method: In this in vitro study, Sixty mandibular premolars with single canal were randomly assigned to three groups (n=20). The root canals were prepared with Medin, ProTaper,
and RaCe rotary instruments based on their manufacturers’ instructions. The debris were collected into pre-weighted Eppendorf tubes. The weight of the extruded debris was
calculated by subtracting the pretreatment weight of the vials. Data were analyzed using the Kruskal-Wallis test at a 5% significance level. Results: Medin instrument caused significantly less debris extrusion in comparison with ProTaper and RaCe (p< 0.05). The differences between the ProTaper and RaCe rotary
systems were not statistically significant (p= 0.752). Conclusion: Within the limitations of this in vitro study, Medin rotary system produced less apical extrusion than ProTaper and RaCe.
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Affiliation(s)
- Mohammadreza Nabavizadeh
- Oral and Dental Disease Research Center, Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mehdi Shokouhi
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojgan Kheirandish
- Dental Student, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Safoora Sahebi
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nooshin Sadatshojaee
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Abbaszadegan
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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21
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Uğur Aydın Z, Erdönmez D, Ateş MO, Doğan T. Efficacy of different irrigation activation systems on bacterial extrusion. AUST ENDOD J 2021; 47:137-142. [PMID: 32820601 DOI: 10.1111/aej.12432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 06/21/2020] [Accepted: 07/26/2020] [Indexed: 01/19/2023]
Abstract
The purpose of this study was to evaluate the quantity of extruded bacteria following with EndoVac, EDDY, EndoActivator (EA) and standard needle irrigation (SNI). Ninety teeth with a single root and canal were included in this study. Fifteen teeth were selected as the negative control group to confirm sterilization. Seventy-five teeth were contaminated with Enterococcus faecalis (E. faecalis) for 4 weeks. Teeth were prepared and divided into five groups (n:15): EndoVac, EDDY, EA, SNI and positive control groups. The extruded bacteria were cultured for bacterial quantification. The counts of extruded bacteria were lower in the EndoVac group compared to the EDDY group (P˂ 0.05). The counts of extrusion bacteria were not different in EA and SNI groups compared to EDDY and EndoVac groups (P > 0.05). Within the limits of this study, EndoVac was found to be more reliable irrigation systems than EDDY in terms of the bacterial extrusion.
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Affiliation(s)
- Zeliha Uğur Aydın
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Demet Erdönmez
- Department of Biology, Faculty of Arts and Science, Aksaray University, Aksaray, Turkey
| | - Melis Oya Ateş
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Tülin Doğan
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
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22
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Al Omari T, El-Farraj H, Arıcan B, Atav Ateş A. Apical debris extrusion of full-sequenced rotary systems in narrow ribbon-shaped canals. AUST ENDOD J 2021; 48:245-250. [PMID: 34125465 DOI: 10.1111/aej.12540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/24/2021] [Accepted: 05/26/2021] [Indexed: 02/05/2023]
Abstract
The apically extruded debris caused by TruNatomy System (TRN), RACE EVO system (RE) and VDW Rotate (VR) systems in mandibular anterior teeth with ribbon-shaped root canals were compared. The root canals (n = 20 in each group) were irrigated with NaOCl 2.5%, and the extruded debris was collected at pre-weighted Eppendorf tubes. The amount of apically extruded debris (mg) and the treatment time (s) were recorded. Tukey pairwise comparisons were performed to compare groups with a 95% confidence level. VR had significantly less debris extrusion values and treatment time than RE and TRN (P < 0.05). Although no difference was observed between RE and TRN in terms of apically extruded debris (P > 0.05), a significant difference in favour of RE was observed in terms of treatment time (P < 0.05). All the instruments extruded debris at varying weights.
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Affiliation(s)
- Taher Al Omari
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Hamza El-Farraj
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Burçin Arıcan
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
| | - Ayfer Atav Ateş
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
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23
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Yılmaz Çırakoglu N, Özbay Y. Apically extruded debris associated with ProTaper Next, ProTaper Gold and TruNatomy systems: An in vitro study. J Dent Res Dent Clin Dent Prospects 2021; 15:30-34. [PMID: 33927838 PMCID: PMC8058151 DOI: 10.34172/joddd.2021.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 11/01/2020] [Indexed: 11/09/2022] Open
Abstract
Background. This research aimed to investigate and compare the amount of apically extruded debris after root canal preparation using ProTaper Next, ProTaper Gold, and TruNatomy systems. Methods. Forty-five extracted mandibular premolar teeth with single canals with similar lengths were used. The root canals were prepared using ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Gold (Dentsply Maillefer, Ballaigues, Switzerland), or TruNatomy (Dentsply Maillefer, Ballaigues, Switzerland) files. Apically extruded debris during preparation was gathered into preweighed Eppendorf tubes. Then the Eppendorf tubes were incubated at 70°C for five days. The Eppendorf tubes were weighed again to determine their final weight plus the extruded debris. Results. The TRN system resulted in significantly less debris extrusion than the PTN system (P <0.05). There was no significant difference between the PTN and PTG groups and between the PTG and TRN groups (P >0.05). Conclusion. All the instrumentation systems caused apical extrusion of debris. However, the TRN system resulted in significantly less debris extrusion than the other systems.
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Affiliation(s)
| | - Yağız Özbay
- Department of Endodontics, Faculty of Dentistry, Karabük University, Karabük, Turkey
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24
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Bürklein S, Donnermeyer D, Hentschel TJ, Schäfer E. Shaping Ability and Debris Extrusion of New Rotary Nickel-Titanium Root Canal Instruments. MATERIALS 2021; 14:ma14051063. [PMID: 33668333 PMCID: PMC7956538 DOI: 10.3390/ma14051063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 11/29/2022]
Abstract
The aim was to evaluate the canal straightening and the amount of apically extruded debris associated with five rotary nickel-titanium when preparing curved root canals. A total of 100 root canals in extracted human teeth (angles of curvatures 20°–30°; radii 5.9–13.5 mm) were divided into five groups (n = 20/group). The groups were balanced with respect to the angle and the radius of canal curvature. The root canals were prepared using conventional austenite 55-NiTi alloy instruments F360, F6 SkyTaper (both Komet, Lemgo, Germany), and the heat-treated NiTi Jizai, Silk-Complex and Silk-Standard instruments (all Mani, Tochigi, Japan) to an apical size 25. The amount of extruded debris was assessed with a micro balance. Statistical analysis was performed using Kruskal–Wallis test with Bonferroni correction at a significance level of p < 0.05. During canal preparation, neither instrument fractures nor procedural preparation errors were noticed. Regarding canal straightening, the use of Jizai instruments resulted in the significantly lowest straightening (p < 0.05), while no significant differences were obtained between all other groups (p > 0.05). Regarding the amount of apically extruded debris, no significant differences between all groups were obtained (p > 0.05). Within the limitations of this study, all instruments performed well, and especially the Jizai instruments showed an excellent shaping ability.
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Affiliation(s)
- Sebastian Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, Westphalian Wilhelms-University, Albert-Schweitzer-Campus 1, Building W 30, 48149 Münster, Germany;
| | - David Donnermeyer
- Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Albert-Schweitzer-Campus 1, Building W 30, 48149 Münster, Germany;
| | - Tim Julian Hentschel
- Private Practice, Zahnärztliche Gemeinschaftspraxis Die Kessels, Brüsseler Straße 11a, 53332 Bornheim, Germany;
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, Westphalian Wilhelms-University, Albert-Schweitzer-Campus 1, Building W 30, 48149 Münster, Germany;
- Correspondence: ; Tel.: +49-251-8347040; Fax: +49-251-8343749
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25
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Ates AA, Arıcan B, Testarelli L, Gambarini G, Zanza A, Seracchiani M. Influence of Clinical Operative Technique on Debris Extrusion of Two Reciprocating Files. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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26
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Düzgün S, Topçuoğlu HS, Kahraman Ö. Evaluation of apically extruded debris during the canal preparation using new heat-treated nickel-titanium files in curved canals. AUST ENDOD J 2020; 47:54-58. [PMID: 33159482 DOI: 10.1111/aej.12459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/01/2020] [Accepted: 10/21/2020] [Indexed: 11/29/2022]
Abstract
This study compared the amount of apically extruded debris associated with different heat-treated Ni-Ti rotary systems during the preparation of curved root canals of mandibular molars. Sixty extracted human mandibular molars were selected. EdgeFile, K3XF, OneCurve (OC) and ROTATE files were used to prepare both mesial canals of teeth. The initial weight of each Eppendorf tube to be used was calculated using an analytical balance prior to instrumentation. After instrumentation, the tubes were then stored for 5 days in an incubator at 70°C. Each tube was reweighed, and the weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. All files caused apical extrusion of debris. There was no statistical difference between the ROTATE, EdgeFile, OC and K3XF systems (P > 0.05). All the heat-treated Ni-Ti rotary systems led to similar apical debris extrusion during the canal preparation.
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Affiliation(s)
- Salih Düzgün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | | | - Ömür Kahraman
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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27
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Postoperative pain after different irrigation activation techniques: a randomized, clinical trial. Odontology 2020; 109:385-392. [PMID: 32915346 DOI: 10.1007/s10266-020-00553-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/03/2020] [Indexed: 11/27/2022]
Abstract
The aim of this study was to assess the effectiveness of irrigation activation techniques on postoperative pain (PP) in mandibular premolar teeth with irreversible pulpitis after single-visit endodontic treatment. A total of 160 patients with symptomatic irreversible pulpitis were included in this prospective randomized clinical study. Four different activation methods were used in mandibular premolar teeth. In group 1, teeth were irrigated with side-port endodontic needles (NI) without any agitation; in groups 2 and 3, sonic activation was performed using EDDY and EndoActivator (EA), respectively; and in group 4, passive ultrasonic irrigation (PUI) was used. Patients' analgesic intake-as well as pain intensity during and after treatment-were recorded at 8, 24, 48 h and 7 days. The data relating to age, sex and analgesic intake was evaluated using the Chi-square test and the preoperative pain and PP intensity at different time intervals was evaluated with the Kruskal-Wallis test at a 5% significance level. Highest PP was recorded at 8 h, pain intensity decreased in all groups by the time. Pain in the NI group was found higher than that of EDDY group at 24 h (P < 0.05). EA and PUI had caused mild pain and had similar pain scores at 24 h. (P > 0.05). No statistically difference was found among the groups with regard to analgesic intake (P > 0.05). Although there were slight differences in PP levels between the groups at 24 h, pain levels decreased in all groups after 24 h. Activation of the irrigation solution did not make any difference in terms of PP after 24 h.
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28
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İnce Yusufoglu S, Keskin NB, Saricam E, Bozkurt DA. Comparison of apical debris extrusion using EDDY, passive ultrasonic activation and photon-initiated photoacoustic streaming irrigation activation devices. AUST ENDOD J 2020; 46:400-404. [PMID: 32881182 DOI: 10.1111/aej.12429] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 06/13/2020] [Accepted: 07/26/2020] [Indexed: 12/13/2022]
Abstract
The study aimed to determine the effect of different irrigation activation systems on the amount of apical debris extrusion in mandibular molar teeth with curved root canals. Sixty extracted mandibular molar teeth were instrumented with HyFlex EDM system and divided into four groups according to irrigation techniques: passive ultrasonic irrigation (PUI), EDDY, photon-initiated photoacoustic streaming (PIPS) and manual irrigation (MI). After the final irrigation, the extruded irrigants were collected into Eppendorf tubes of known weights. The amount of extruded debris was obtained by subtracting the weight from the initial weight of the tube. The Kruskal-Wallis test was used for statistical analysis. EDDY caused significantly more debris extrusion than the other irrigation activation systems (P < 0.001). PUI caused less apical debris extrusion but there was no statistical difference between PUI, PIPS and MI (P > 0.05). The EDDY activation system was associated with the highest amount of debris extrusion in curved root canals.
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Affiliation(s)
- Selen İnce Yusufoglu
- Faculty of Dentistry, Department of Endodontics, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Neslihan Büsra Keskin
- Faculty of Dentistry, Department of Endodontics, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Esma Saricam
- Faculty of Dentistry, Department of Endodontics, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Durmus Alperen Bozkurt
- Faculty of Dentistry, Department of Endodontics, Konya Necmettin Erbakan University, Konya, Turkey
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Asif A, Jeevanandan G, Govindaraju L, Vignesh R, G Subramanian EM. Comparative Evaluation of Extrusion of Apical Debris in Primary Anterior Teeth using Two Different Rotary Systems and Hand Files: An In Vitro Study. Contemp Clin Dent 2020; 10:512-516. [PMID: 32308330 PMCID: PMC7150551 DOI: 10.4103/ccd.ccd_884_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The success of endodontic treatment depends on the chemomechanical preparation of the tooth. However, the debris produced during canal preparation may extrude through the apical foramen causing postoperative complications. Aim The aim of this study is to compare the apical debris extrusion during root canal preparation in primary anterior teeth using hand files, rotary ProTaper files, and rotary Kedo-S files. Materials and Methods Forty-five freshly extracted primary canine with mature apices and a single canal were randomly divided into three groups for instrumentation as follows (n = 15): Group 1: hand files; Group 2: rotary ProTaper files; and Group 3: rotary Kedo-S files. Myers and Montgomery experimental model was used for this study. Apically extruded debris collected in a preweighed Eppendorf tubes was placed in the incubator at 70°C for 5 days. The weight of the debris collected was determined by subtracting the pre- and post-instrumentation weight of the Eppendorf tubes. The data collected were analyzed using the analysis of variance and Tukey's post-hoc tests. Results Hand files produced more apical debris extrusion than ProTaper and Kedo-S files (P < 0.05) while Kedo-S produced the least (P < 0.05). Conclusion All instrumentation systems cause apical debris extrusion. Kedo-S produced less apical debris extrusion when compared to the hand files and ProTaper files.
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Affiliation(s)
- Ahsana Asif
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Ganesh Jeevanandan
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Lavanya Govindaraju
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - R Vignesh
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - E M G Subramanian
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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30
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Amaral AP, Limongi PBOC, Fontana CE, Martin ASD, Bueno CEDS, Pinheiro SL. Debris Apically Extruded by Two Reciprocating Systems: A Comparative Quantitative Study. Eur J Dent 2019; 13:625-628. [PMID: 31891980 PMCID: PMC6938432 DOI: 10.1055/s-0039-3400550] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective
The objective of this study was to quantify the amount of debris apically extruded after instrumentation with two reciprocating systems.
Materials and Methods
Forty-two single-rooted mandibular premolars with only one straight root canal and apical diameter compatible with a no. 15 K-file were randomly divided into two groups (
n
= 21) according to the instrument used: ProDesign R (Easy Equipamentos; Belo Horizonte, Minas Gerais, Brazil) and Reciproc Blue (VDW; Munich, Germany). Dry Eppendorf tubes were weighed three consecutive times for the initial mean weight. A silicone stopper was then fitted into the mouth of the tube. Each tooth was inserted through the stopper up to the cementoenamel junction and instrumented with one of the two systems to the predetermined working length (18 mm). The root canals were instrumented per root thirds. At each instrumented root third, the canal was irrigated with 3 mL of double-distilled water, followed by patency control. Each stopper was then separated from the tube and tubes were incubated at 70°C for 5 days. Tubes were again weighed, and the amount of extruded debris was calculated by subtracting the initial mean weight from the final mean weight.
Statistical Analysis
Results were analyzed using the Mann–Whitney test at a 5% significance level.
Results
No significant difference was observed in debris extrusion between the ProDesign R and Reciproc Blue systems (
p
= 0.7557).
Conclusions
The two reciprocating systems tested produced similar amounts of postinstrumentation apically extruded debris.
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Affiliation(s)
| | | | - Carlos Eduardo Fontana
- Pontifical Catholic University of Campinas (PUC-Campinas), Center for Health Sciences, Postgraduate Program in Health Sciences, Campinas, São Paulo, Brazil
| | | | | | - Sérgio Luiz Pinheiro
- Pontifical Catholic University of Campinas (PUC-Campinas), Center for Health Sciences, Postgraduate Program in Health Sciences, Campinas, São Paulo, Brazil
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31
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Topçuoğlu HS, Demirbuga S, Topçuoğlu G. Evaluation of apically extruded debris during the removal of canal filling material using three different Ni-Ti systems and hand files in teeth with simulated apical root resorption. Int Endod J 2019; 53:403-409. [PMID: 31605377 DOI: 10.1111/iej.13234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 01/23/2023]
Abstract
AIM To compare the weight of apically extruded debris produced during the removal of root canal filling material using various files in extracted teeth with simulated apical root resorption. METHODOLOGY The root canals of one hundred and twenty extracted mandibular premolar teeth were prepared with Revo-S files and filled using a cold lateral compaction technique with gutta-percha and a resin-based sealer (AdSeal; Meta-Biomed, Cheongwon, Korea). Sixty teeth were randomly assigned to four control groups (hand file, ProTaper Universal retreatment file, D-RaCe retreatment file, and Reciproc file) for the removal of root canal filling material. The apical portion of the remaining 60 teeth was modified to simulate apical root resoption, and the teeth were then randomly divided into 4 experimental groups (using the same techniques as in the control groups) for the removal of root canal filling material. Apically extruded debris was collected into pre-weighed Eppendorf tubes and then dried. The mean weight of the apically extruded debris was assessed with an analytical balance to an accuracy of 10-4 g. Data were analysed using two-way analysis of variance and a Tukey's post hoc test. RESULTS In the simulated apical root resorption groups, all file systems were associated with significantly more debris extrusion compared to the groups without simulated resorption (P < 0.05). The amount of apically extruded debris was greatest in the hand file groups compared with the other groups (P < 0.05). In the groups with simulated apical root resorption, the Reciproc system was associated with the least weight of apically extruded debris (P < 0.05), whereas there was no significant difference between the ProTaper Universal retreatment and D-RaCe files (P > 0.05). In the groups without simulated apical root resorption, there was no significant difference between Reciproc, ProTaper Universal retreatment and D-RaCe retreatment files (P> 0.05). The time required to remove the root canal filling material was as follows: hand file > ProTaper Universal retreatment = D-RaCe retreatment > Reciproc (P < 0.05). CONCLUSIONS The weight of apically extruded debris was significantly greater in teeth with simulated apical root resorption than in those teeth without simulated apical root resorption. Hand files were associated with significantly more apically extruded debris in all groups during removal of root canal filling material.
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Affiliation(s)
- H S Topçuoğlu
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - S Demirbuga
- Department of Restorative Dentistry, Erciyes University, Kayseri, Turkey
| | - G Topçuoğlu
- Private Practice in Pedodontics, Kayseri, Turkey
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Doğanay Yıldız E, Arslan H. The effect of blue thermal treatment on endodontic instruments and apical debris extrusion during retreatment procedures. Int Endod J 2019; 52:1629-1634. [PMID: 31131904 DOI: 10.1111/iej.13161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/22/2019] [Indexed: 01/03/2023]
Abstract
AIM To determine the effect of blue thermal treatment on Reciproc (VDW, Munich, Germany) endodontic instruments and the amount of apically extruded debris during retreatment procedures. METHODOLOGY Thirty extracted mandibular molar teeth having mesial roots with a degree of curvature less than 20° and having an initial apical size equivalent to a size 10 K-file were selected. The mesial roots of the teeth were removed from the cementoenamel junction to obtain a 15-mm root length. The mesiobuccal canals were prepared to size F2 using the ProTaper Universal system (Dentsply Sirona, Ballaigues, Switzerland), filled with gutta-percha and 2Seal (VDW) using the lateral compaction technique and then randomly divided into two groups (n = 15). The root fillings were removed with one of the following instruments using a crown-down preparation technique: M-Wire Reciproc or Reciproc Blue (both VDW). Apically extruded debris was collected in pre-weighed Eppendorf tubes. The Eppendorf tubes were then stored in an incubator at 70 °C for five days to evaporate the distilled water. The data were analysed using the Mann-Whitney U test (P = 0.05). RESULTS Reciproc Blue (1.42 ± 0.4491 mg) extruded significantly less debris apically than M-Wire Reciproc (2.56 ± 1.0232 mg) (P < 0.05). CONCLUSIONS Blue thermal treatment of Reciproc instruments was associated with less debris extrusion during retreatment procedures.
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Affiliation(s)
- E Doğanay Yıldız
- Department of Endodontics, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey
| | - H Arslan
- Department of Endodontics, Faculty of Dentistry, Health Sciences University, İstanbul, Turkey
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KELEŞ A, Uzunoğlu Özyürek E, Uysal S, Tuncel B, Uyanik Ö, Nagaş E. Comparison of Apically Extruded Debris Associated with Different Nickel–Titanium Systems. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.507866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Reciproc and Reciproc Blue in the removal of bioceramic and resin-based sealers in retreatment procedures. Clin Oral Investig 2019; 24:405-416. [DOI: 10.1007/s00784-019-02956-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/07/2019] [Indexed: 12/12/2022]
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de Cristofaro Almeida G, Aun DP, Resende PD, Peixoto IFDC, Viana ACD, Buono VTL, de Azevedo Bahia MG. Comparative analysis of torque and apical force to assess the cutting behaviour of ProTaper Next and ProTaper Universal endodontic instruments. AUST ENDOD J 2019; 46:52-59. [PMID: 31087492 DOI: 10.1111/aej.12351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2019] [Indexed: 11/28/2022]
Abstract
This study assessed the cutting properties of two Nickel Titanium file systems with different designs and manufacturing materials. ProTaper Next X1 and X2 (PTN; Dentsply Sirona) and ProTaper Universal S2 and F1 (PTU; Dentsply Sirona) instruments were employed. The cutting parameters, that is torque and apical forces, were determined using a specially designed bench-testing machine. Dimensional and geometric parameters were considered to evaluate the results. The average maximum torque values showed statistically significant differences (P < 0.05) among all instruments. Apical force for PTN X2 and PTU F1 instruments initially decreased and then experienced a rapid increase in the last 2 mm of the canal. For PTN X1 and PTU S2, apical force increased during the entire test. When compared to PTU files, PTN required higher torque and apical forces during the shaping procedure. The results lead us to conclude that PTN instruments demonstrated a lower cutting efficiency than PTU.
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Affiliation(s)
- Gustavo de Cristofaro Almeida
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Diego Pinheiro Aun
- Department of Metallurgical and Materials Engineering, School of Engineering, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Pedro Damas Resende
- Department of Metallurgical and Materials Engineering, School of Engineering, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Isabella Faria da Cunha Peixoto
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ana Cecília Diniz Viana
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Vicente Tadeu Lopes Buono
- Department of Metallurgical and Materials Engineering, School of Engineering, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Maria Guiomar de Azevedo Bahia
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Keskin C, Sarıyılmaz E. Apically extruded debris and irrigants during root canal filling material removal using Reciproc Blue, WaveOne Gold, R-Endo and ProTaper Next systems. J Dent Res Dent Clin Dent Prospects 2019; 12:272-276. [PMID: 30774793 PMCID: PMC6368952 DOI: 10.15171/joddd.2018.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 11/18/2018] [Indexed: 11/13/2022] Open
Abstract
Background. The present study aimed to compare the amount of apically extruded debris and irrigants produced by various nickel-titanium instruments.
Methods. A total of 100 single-rooted mandibular premolar teeth were root canal treated and prepared for agar gel model. The root canal fillings were removed using Reciproc Blue, ProTaper Next, R-Endo, WaveOne Gold systems or hand instrumentation. The mean weights of apically extruded materials were calculated. Data were statistically analyzed using one-way ANOVA and post hoc Bonferroni tests.
Results. Hand instrumentation resulted in significantly more debris and irrigants than other systems (P<0.05). The mean amount of apically extruded debris and irrigants produced by Reciproc Blue system was significantly greater than motordriven instruments (P<0.05). No significant difference was detected between ProTaper Next and WaveOne Gold systems (P>0.05), while they both produced significantly less apically extruded material than R-Endo system (P<0.05).
Conclusion. All the instruments caused apical extrusion. ProTaper Next and WaveOne Gold systems were associated with significantly less apical extrusion.
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Affiliation(s)
- Cangul Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - Evren Sarıyılmaz
- Department of Endodontics, Faculty of Dentistry, Ordu University Ordu, Turkey
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Karataslioglu E, Arslan H, Er G, Avci E. Influence of canal curvature on the amount of apically extruded debris determined by using three‐dimensional determination method. AUST ENDOD J 2018; 45:216-224. [DOI: 10.1111/aej.12311] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Emrah Karataslioglu
- Department of Endodontics Faculty of Dentistry İzmir Katip Çelebi University İzmir Turkey
| | - Hakan Arslan
- Department of Endodontics Faculty of Dentistry Atatürk University Erzurum Turkey
| | - Gamze Er
- Department of Endodontics Faculty of Dentistry İzmir Katip Çelebi University İzmir Turkey
| | - Ece Avci
- Department of Endodontics Faculty of Dentistry İzmir Katip Çelebi University İzmir Turkey
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Effects of Different Glide Path Files on Apical Debris Extrusion in Curved Root Canals. J Endod 2018; 44:1191-1194. [DOI: 10.1016/j.joen.2018.04.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/13/2018] [Accepted: 04/16/2018] [Indexed: 11/20/2022]
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Apically Extruded Debris during Root Canal Instrumentation with Reciproc Blue, HyFlex EDM, and XP-endo Shaper Nickel-titanium Files. J Endod 2018; 44:856-859. [DOI: 10.1016/j.joen.2018.01.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/25/2018] [Accepted: 01/31/2018] [Indexed: 11/21/2022]
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Topçuoğlu HS, Ulusan Ö, Topçuoğlu G, Biricik E. Apically extruded debris during the removal of canal filling material from root canals using three techniques. ACTA ACUST UNITED AC 2018; 9:e12337. [PMID: 29603889 DOI: 10.1111/jicd.12337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/01/2018] [Indexed: 01/13/2023]
Abstract
AIM In the present study, we evaluated the effect of the single-cone technique (SCT), cold lateral compaction (CLC), and wave vertical compaction (WVC) technique performed using two different sealers on the amount of apically extruded debris (AED) produced during the removal of canal filling material. METHODS Ninety extracted mandibular premolars were prepared with ProTaper instruments. The teeth were then randomly assigned to six groups (N = 15) for root canal filling: (a) group 1, CLC+AH Plus; (b) group 2, SCT+AH Plus; (c) group 3, WVC+AH Plus; (d) group 4, CLC+MTA Fillapex; (e) group 5, SCT+MTA Fillapex; and (f) group 6, WVC+MTA Fillapex. In all groups, the removal of canal filling material was performed with ProTaper retreatment instruments. The mean weight of the AED was assessed with an analytical balance. RESULTS The amount of AED was lowest in groups 2 and 5 (P < .05), with no difference between these groups (P > .05). Groups 3 and 6 produced the greatest amount of extruded debris (P < .05); there was no difference between these groups (P > .05). Additionally, there was no difference between groups 1 and 4 (P > .05). There was no significant difference among the groups regarding sealer type (P > .05). CONCLUSIONS The canal filling technique used affected the amount of AED produced during the removal of canal filling material, but not sealer type.
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Affiliation(s)
- Hüseyin S Topçuoğlu
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Özge Ulusan
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | | | - Eda Biricik
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Shetty VP, Naik BD, Pachlag AK, Yeli MM. Comparative evaluation of the amount of debris extruded apically using conventional syringe, passive ultrasonic irrigation and EndoIrrigator Plus system: An in vitro study. J Conserv Dent 2018; 20:411-414. [PMID: 29430092 PMCID: PMC5799986 DOI: 10.4103/jcd.jcd_200_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim: The aim of this study is to compare the effects of conventional syringe, passive ultrasonic irrigation (PUI), and EndoIrrigator Plus on the amount of apically extruded debris. Materials and Methods: Thirty extracted human mandibular premolars were selected and randomly assigned to three groups (n = 10). The root canals were irrigated with conventional syringe, PUI, and EndoIrrigator Plus. Sodium hypochlorite was used as an irrigant, and debris was collected in a previously described experimental model (Myers and Montgomery 1991). It was then stored in an incubator at 37°C for 10 days to evaporate the irrigant before weighing the dry debris. The mean weight of debris was assessed, one-way analysis of variance was used for comparison of values, and post hoc Tukey's test was used between groups (P = 0.05). Results: The EndoIrrigator Plus group extruded significantly less debris than PUI and conventional syringe groups (P < 0.05). Furthermore, PUI group extruded significantly less debris than conventional syringe irrigation group (P < 0.05). Conclusions: 1. All the three irrigation systems were associated with apical extrusion of debris, 2. EndoIrrigator Plus system extruded significantly less debris than the PUI system and the conventional syringe irrigation system, 3. PUI system extruded significantly less debris than the conventional syringe irrigation system.
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Affiliation(s)
- Vidhi Prabhakar Shetty
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Balaram Damodar Naik
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Amit Kashinath Pachlag
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Mahantesh Mrityunjay Yeli
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
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Delai D, Boijink D, Hoppe CB, Grecca AS, Kopper PMP. Apically extruded debris in filling removal of curved canals using 3 NiTi systems and hand files. Braz Dent J 2018; 29:54-59. [PMID: 29267525 DOI: 10.1590/0103-6440201801760] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 09/19/2017] [Indexed: 11/21/2022] Open
Abstract
Abstract The aim of this study was to assess the amount of apically extruded debris during filling removal with WaveOne Gold (WOG), ProTaper Universal Retreatment (PTR), D-RaCe Retreatment (DRR) or hand files (HF), to compare the working time during filling removal, and to describe failures of NiTi instruments. Forty mesiobuccal roots of maxillary first molars were prepared with WOG Primary, obturated and divided into 4 groups (n=10), according to the instruments used: WOG, PTR, DRR or HF. Distilled water was used as irrigant and the extruded debris were collected in Eppendorf tubes and dried. The amount of extruded debris was determined by subtracting the final from the initial weight. The time of filling removal for each canal was recorded and the instruments used were analyzed pre and post-operatively by SEM. Kruskal-Wallis and Dunn’s test analyzed extruded debris data and ANOVA, followed by Tukey’s test, compared the working time data (a=0.05). Instrument deformation and fracture were described. WOG produced significantly less debris compared with HF and DRR (p<0.05), and similar to PTR (p>0.05). HF, PTR and DRR showed no significant difference (p>0.05). Working time in HF group was significantly higher than others (p<0.05). SEM analyses showed, from the 18 instruments evaluated, 3 fractures and 10 deformations. All instruments tested caused debris extrusion. WOG was associated with less extrusion than DRR and HF. Filling removal with HF was slower than with the other instruments. All NiTi systems presented fracture and deformation.
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Genc Sen O, Kaya M. Comparative Safety of Needle, EndoActivator, and Laser-Activated Irrigation in Overinstrumented Root Canals. Photomed Laser Surg 2017; 36:198-202. [PMID: 29265956 DOI: 10.1089/pho.2017.4380] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To evaluate the safety of sodium hypochlorite (NaOCl) irrigation using three different techniques during the final rinse in overinstrumented root canals. BACKGROUND DATA The effect of irrigant activation on irrigant extrusion from overinstrumented root canals is still unclear. METHODS A total of 30 single-rooted teeth were decoronated. The working lengths were determined and the roots were divided into two groups of 15 teeth each: group 1, instrumentation 0.5 mm short of the apical foramen and group 2, instrumentation 0.5 mm beyond the apical foramen (overinstrumented). Needle irrigation (NI), sonic irrigation with EndoActivator (EAI), and laser-activated irrigation (LAI) were used for the final rinse in each group; each root underwent the three irrigation procedures in a randomized crossover manner. A modified container-foam model was used to collect apically extruded NaOCl. The weight of the extruded NaOCl was calculated by subtracting the initial weights of the containers from their final weights. All data were statistically analyzed. RESULTS The amount of NaOCl extrusion was similar with all three irrigation systems in group 1. In group 2, the amount of extruded NaOCl was significantly greater with EAI than with NI and LAI. EAI and LAI caused significantly greater extrusion in group 2 than in group 1. CONCLUSIONS EAI, NI, and LAI are equally safe for irrigating canals with intact apices. However, the risk of irrigant extrusion can increase in overinstrumented canals, with EAI associated with a greater risk compared with NI and LAI.
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Affiliation(s)
- Ozgur Genc Sen
- Department of Endodontics, Faculty of Dentistry, Yuzuncu Yil University , Van, Turkey
| | - Melih Kaya
- Department of Endodontics, Faculty of Dentistry, Yuzuncu Yil University , Van, Turkey
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Yao K, Satake K, Watanabe S, Ebihara A, Kobayashi C, Okiji T. Effect of Laser Energy and Tip Insertion Depth on the Pressure Generated Outside the Apical Foramen During Er:YAG Laser-Activated Root Canal Irrigation. Photomed Laser Surg 2017; 35:682-687. [DOI: 10.1089/pho.2017.4268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Kanako Yao
- Department of Pulp Biology and Endodontics, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Kazuhisa Satake
- Department of Pulp Biology and Endodontics, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Satoshi Watanabe
- Department of Pulp Biology and Endodontics, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Arata Ebihara
- Department of Pulp Biology and Endodontics, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Chihiro Kobayashi
- Oral Diagnosis and General Dentistry Dental Hospital, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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Thakur B, Pawar AM, Kfir A, Neelakantan P. Extrusion of Debris from Primary Molar Root Canals following Instrumentation with Traditional and New File Systems. J Contemp Dent Pract 2017; 18:1040-1044. [PMID: 29109318 DOI: 10.5005/jp-journals-10024-2172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION To assess the amount of debris extruded apically during instrumentation of distal canals of extracted primary molars by three instrument systems [ProTaper Universal (PTU), ProTaper NEXT (PTN), and self-adjusting file (SAF)] compared with conventional stainless steel hand K-files (HF, control). MATERIALS AND METHODS Primary mandibular molars (n = 120) with a single distal canal were selected and randomly divided into four groups (n = 30) for root canal instrumentation using group I, HF (to size 0.30/0.02 taper), group II, PTU (to size F3), group III, PTN (to size X3), and group IV, SAF. Debris extruded during instrumentation was collected in preweighed Eppendorf tubes, stored in an incubator at 70°C for 5 days and then weighed. Statistical analysis was performed by one-way analysis of variance (ANOVA), followed by Turkey's post hoc test (p = 0.05). RESULTS All the groups resulted in extrusion of debris. There was statistically significant difference (p < 0.001) in the debris extrusion between the three groups: HF (0.00133 ± 0.00012), PTU (0.00109 ± 0.00005), PTN (0.00052 ± 0.00008), and SAF (0.00026 ± 0.00004). CONCLUSION Instrumentation with SAF resulted in the least debris extrusion when used for shaping root canals of primary molar teeth. CLINICAL SIGNIFICANCE Debris extrusion in primary teeth poses an adverse effect on the stem cells and may also alter the permanent dental germ. Debris extrusion is rarely reported for primary teeth and it is important for the clinician to know which endodontic instrumentation leads to less extrusion of debris.
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Affiliation(s)
- Bhagyashree Thakur
- Department of Dentistry, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India, Phone: +919867636233 e-mail:
| | - Anda Kfir
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Prasanna Neelakantan
- Department of Endodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong
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Tziafas D, Alraeesi D, Al Hormoodi R, Ataya M, Fezai H, Aga N. Preparation Prerequisites for Effective Irrigation of Apical Root Canal: A Critical Review. J Clin Exp Dent 2017; 9:e1256-e1263. [PMID: 29167718 PMCID: PMC5694157 DOI: 10.4317/jced.54117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/09/2017] [Indexed: 11/05/2022] Open
Abstract
Background It is well recognized that disinfection of the complex root canal system at the apical root canal remains the most critical therapeutic measure to treat apical periodontitis. Material and Methods Observational and experimental data in relation to the anatomy of the apical root canal in different tooth types and the cross sectional diameters of the apical part of the most commonly used hand and rotary files are critically reviewed. Results The present data analysis confirm that the challenging issue of antibacterial efficacy of modern preparation protocols in non-surgical endodontics requires more attention to apical root canal irrigation as a balance between safety and effectiveness. Ex vivo investigations clearly indicate that a specific design of the chemo-mechanical preparation is needed at the onset of RCT, more particularly in infected teeth. Design should be based on specific anatomical parameters, and must determine the appropriate size and taper of preparation as pre-requirements for effective and safe apical irrigation. Conclusions The optimal irrigation protocols might be designed on the basis of technical specifications of the preparations procedures, such as the penetration depth, the type of the needle, the required time for continuous irrigant flow, the concentration of NaOCl, and the activation parameters. Key words:Endodontics, root canal treatment, instrumentation, irrigation, apical root canal.
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Affiliation(s)
- Dimitrios Tziafas
- DDS, PhD, Professor in Endodontics, Hamdan Bin Mohamed College of Dental Medicine, MBR University of Medicine and Health Sciences, DHCC Dubai, UAE
| | - Dana Alraeesi
- BDS, Dentist, resident of Postgraduate Master Program in Endodontics, Hamdan Bin Mohamed College of Dental Medicine, MBR University of Medicine and Health Sciences, DHCC Dubai, UAE
| | - Reem Al Hormoodi
- BDS, Dentist, resident of Postgraduate Master Program in Endodontics, Hamdan Bin Mohamed College of Dental Medicine, MBR University of Medicine and Health Sciences, DHCC Dubai, UAE
| | - Maamoun Ataya
- BDS, Dentist, resident of Postgraduate Master Program in Endodontics, Hamdan Bin Mohamed College of Dental Medicine, MBR University of Medicine and Health Sciences, DHCC Dubai, UAE
| | - Hessa Fezai
- BDS, Dentist, resident of Postgraduate Master Program in Endodontics, Hamdan Bin Mohamed College of Dental Medicine, MBR University of Medicine and Health Sciences, DHCC Dubai, UAE
| | - Nausheen Aga
- BDS, Dentist, resident of Postgraduate Master Program in Endodontics, Hamdan Bin Mohamed College of Dental Medicine, MBR University of Medicine and Health Sciences, DHCC Dubai, UAE
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Saberi E, Zahedani SS, Ebrahimipour S. Apical Extrusion of Intracanal Bacteria with Single File and Multifile Rotary Instrumentation Systems. J Int Soc Prev Community Dent 2017; 7:292-296. [PMID: 29026702 PMCID: PMC5629858 DOI: 10.4103/jispcd.jispcd_199_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/24/2017] [Indexed: 11/09/2022] Open
Abstract
Aims and Objectives: Instrumentation techniques may cause extrusion of microorganisms and their products into the periapical region resulting inflammation and treatment failure. The aim of this ex vivo study was comparing the apical bacterial extrusion in canals prepared with single file versus multiple file rotary systems. Materials and Methods: Ninety-two human single-rooted mandibular first premolars were used. Endodontic access cavities were prepared, and root canals were contaminated with an Enterococcus faecalis (E. faecalis) suspension. The samples were incubated at 37°C for 30 days; the contaminated teeth were divided into four groups of 20 specimens each (1: Reciproc, 2: Mtwo, 3: Neoniti A1, 4: Safesider). Six teeth were not infected and each were prepared with one of the above instruments were considered as negative and six teeth which had been previously infected, were used as positive control groups. Extruded bacteria from the apical foramen during instrumentation were collected into vials containing 0.9% NaCl. The microbial samples were taken from the vials and incubated in brain heart agar medium for 24 h. The resulting bacterial titer, in colony-forming units per mL, was determined. The data entered into SPSS 18 software and were analyzed by Kruskal–Wallis and Mann–Whitney U-tests at 0.05 significance level. Results: Mtwo multifile system showed significantly less bacterial extrusion than Safesider (P = 0.015) and Neoniti A1 (P = 0.042) but did not show significant difference with Reciproc system (P = 0.25). Conclusions: All instrumentation systems extruded bacteria beyond the apical foramen. However, this study showed that Mtwo multifile rotary system extruded fewer bacteria.
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Affiliation(s)
- Eshaghali Saberi
- Department of Endodontics, Oral and Dental Diseases Research Center, Dental School, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shahram Shahraki Zahedani
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sediqe Ebrahimipour
- Department of Endodontics, Faculty of Dentistry and Dental Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Verma M, Meena N, Kumari RA, Mallandur S, Vikram R, Gowda V. Comparison of apical debris extrusion during root canal preparation using instrumentation techniques with two operating principles: An in vitro study. J Conserv Dent 2017; 20:96-99. [PMID: 28855755 PMCID: PMC5564252 DOI: 10.4103/0972-0707.212239] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Aims: The aim of this study was to quantify the debris extruded apically from teeth using rotary and reciprocation instrumentation systems. Subjects and Methods: Eighty extracted human mandibular premolars with single canals and similar lengths were instrumented using ProTaper Universal (40, 06; Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Next (40, 06; Dentsply Maillefer, Ballaigues, Switzerland), WaveOne (40, 06; Dentsply Maillefer, Ballaigues, Switzerland), and Reciproc (R40; VDW GmbH, Munich, Germany). Debris extruded during instrumentation was collected into preweighed Eppendorf tubes, which were then stored in an incubator at 70°C for 5 days. The final weight of the Eppendorf tubes with the extruded debris was calculated after obtaining the mean of three consecutive weights obtained for each tube. Statistical Analysis Used: Statistical analysis was performed using SPSS version 16.0 software. The groups were compared using the Kruskal–Wallis test for all variables. Results: There was no statistically significant difference between the groups (P = 0.1114). However, the ProTaper Universal group produced more extrusion and ProTaper Next produced least debris extrusion among the instrument groups (P > 0.05). Conclusions: All instrumentation techniques were associated with extruded debris.
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Affiliation(s)
- Mudita Verma
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College, Bengaluru, Karnataka, India
| | - N Meena
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College, Bengaluru, Karnataka, India
| | - R Anitha Kumari
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College, Bengaluru, Karnataka, India
| | - Sudhanva Mallandur
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College, Bengaluru, Karnataka, India
| | - R Vikram
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College, Bengaluru, Karnataka, India
| | - Vishwas Gowda
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College, Bengaluru, Karnataka, India
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Nevares G, Romeiro K, Albuquerque D, Xavier F, Fogel H, Freire L, Cunha R. Evaluation of Apically Extruded Debris during Root Canal Retreatment Using ProTaper Next and Reciproc in Severely Curved Canals. IRANIAN ENDODONTIC JOURNAL 2017; 12:323-328. [PMID: 28808459 PMCID: PMC5527208 DOI: 10.22037/iej.v12i3.15850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION To compare the apical extrusion of debris produced during root obturating material removal from severely curved root canals using either Reciproc (REC) or ProTaper Next (PTN) systems. METHODS AND MATERIALS Twenty-six mesial canals of lower molars were instrumented, filled and allocated into two groups (n=13). Micro-computed tomographic images were performed to determine the root canal configuration (Vertucci's type IV) and initial volume of obturation. One Eppendorf tube was assigned per canal and weighed (10-4g) before and after removal of the obturating material. The difference between the initial and final weights was calculated and statistically evaluated. RESULTS Apical extrusion of debris was confirmed in all samples, and the mean amount of apical extrusion was similar between both groups (0.061±0.014 g in PTN vs. 0.065±0.016 g in REC samples) (P<0.05). CONCLUSION Both systems caused apical extrusion of debris with no differences between PTN and REC systems.
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Affiliation(s)
- Giselle Nevares
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, PE, Brazil
| | - Kaline Romeiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, PE, Brazil
| | - Diana Albuquerque
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, PE, Brazil
| | - Felipe Xavier
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, PE, Brazil
| | - Howard Fogel
- Division of Endodontics, College of Dentistry, University of Manitoba, Winnipeg, MB, Canada
| | - Laila Freire
- School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Rodrigo Cunha
- Division of Endodontics, College of Dentistry, University of Manitoba, Winnipeg, MB, Canada
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Silva PB, Krolow AM, Pilownic KJ, Casarin RP, Lima RKP, Leonardo RDT, Pappen FG. Apical Extrusion of Debris and Irrigants Using Different Irrigation Needles. Braz Dent J 2017; 27:192-5. [PMID: 27058383 DOI: 10.1590/0103-6440201600382] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 02/16/2016] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the influence of irrigation tip, root canal curvature and final apical diameter on periapical debris and irrigant extrusion during root canal instrumentation. After being classified as mildly or moderately curved, the mesiobuccal root canals of 90 human molars were instrumented. The teeth were allocated into three groups according to the used needle type: a flat open-end needle (Group 1), a side-vented needle (Group 2) or a double side-vented needle (Group 3). The amount of extruded material after instrumentation was calculated for each group. The differences in irrigant and debris extrusion between the experimental groups were analyzed with the Mann-Whitney U test. Irrigation tips and final instrument diameter differences were analyzed with the Kruskal-Wallis test. Multiple groups were compared using the Mann-Whitney U-test with a Bonferroni correction at α=0.05. The amount of extruded material from the double side-vented needle was significantly less than the open-ended flat needle (p=0.008), but there was no difference compared to the side-vented needle (p=0.929). The results showed no effect of root curvature and final apical diameter on the amount of irrigant and debris extrusion (p>0.05). The double side-vented needles generated the least material extrusion to the periapical tissues. Irrigation needle type had the greatest influence on periapical irrigant and debris extrusion and the double side-vented needles may be safely used during endodontic therapy.
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Affiliation(s)
- Paula Barcellos Silva
- Department of Semiology and Clinics, School of Dentistry, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Angélica Mohnsam Krolow
- Department of Semiology and Clinics, School of Dentistry, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Katerine Jahnecke Pilownic
- Department of Semiology and Clinics, School of Dentistry, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Renata Picanço Casarin
- Department of Semiology and Clinics, School of Dentistry, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Regina Karla Pontes Lima
- Department of Restorative Dentistry, Araraquara Dental School, Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Renato de Toledo Leonardo
- Department of Restorative Dentistry, Araraquara Dental School, Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Fernanda Geraldo Pappen
- Department of Semiology and Clinics, School of Dentistry, Universidade Federal de Pelotas, Pelotas, RS, Brazil
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